Topical and oral CAM in acne: a review of the empirical evidence and a consideration of its context Magin P J, Adams J, Pond C D, Smith W CRD summary This review examined topical and oral complementary and alternative treatments for acne. The authors concluded that the evidence base was limited; this reflects the poor quality of most of the included studies. The review methodology was poorly reported and the reliability of the review's conclusions is therefore unclear. Authors' objectives To examine the efficacy of different methods of complementary and alternative medicine (CAM) in the treatment of acne. Searching MEDLINE, EMBASE, AMED, DARE and the Cochrane Library were searched using the reported search terms. The dates of the search were not reported. The reference lists of identified articles were checked. Only studies reported in English were eligible. Study selection Study designs of evaluations included in the review Inclusion criteria were not explicitly reported, although the authors did state that no studies were excluded on methodological grounds. Randomised controlled trials (RCTs), clinical controlled trials and before-and-after studies were included in the review. Specific interventions included in the review Studies of topical and oral CAM interventions were eligible for inclusion. Other CAM therapies, such as acupuncture, skin pricking, cupping and blood letting, were excluded from the review. The interventions included in the review were tea tree oil, Nigerian Toto oil and soap, Ocimum gratissimum oil, Ocimum basilicum leaves, Aloe vera, linoleic acid, gluconolactone, glycolic acid, ayerverdic herbal formulations, gugulipid, mask containing several Chinese ingredients, compound oldenlandis mixture, Chinese-Japanese Kampo formulations, Japanese shark liver and gallbladder extract (isolutrol and benzoyl peroxide), pyroxidine and vitamin A. The comparators included placebo and active interventions. Participants included in the review Studies of participants with acne were eligible for inclusion. Limited details on the severity of the participants' acne and participant demographics were provided. Outcomes assessed in the review Inclusion criteria were not stated. Most of the studies included in the review reported efficacy as improvements in inflammatory and non-inflammatory lesions; others reported 'response to treatment' or incidental symptoms. How were decisions on the relevance of primary studies made? The authors did not state how the papers were selected for the review, or how many reviewers performed the selection. Assessment of study quality The authors did not explicitly state the criteria on which validity was assessed. However, from the details provided in the table of included studies and the text, the criteria appeared to have included randomisation, blinding, use of a power calculation, use of a placebo control group, and rigour of the outcome assessment. It was unclear how the validity assessment was performed. Database of Abstracts of Reviews of Effects (DARE) Produced by the Centre for Reviews and Dissemination Copyright © 2018 University of York Page: 1 / 4